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BOARD OF TRUSTEES SAN JOAQUIN LOCAL HEALTH DISTRICT SERVING <br /> James Culbertson, Pres. <br /> Patricia E. Vannuccl, Secy City of Lodi <br /> Anthonette Van Spronson 1601 East Hazelton Avenue, P. O. Box 2009 San Joaquln County <br /> Eerr Plmentel Stockton, Callfornia 95201 city of E,calon <br /> Fern Bupbee <br /> City of Manteca Daniel L. Flores 209/466-6781 City of Ripon <br /> John D. Masi, M.O. City of Stockton <br /> City of Tracy <br /> William J. Wade Jopi Khanna, M.D., M.P.H., District Health Olflcer <br /> San Joaquin County <br /> Mary Anna Love San Joaquin County <br /> I <br /> AUTHORIZATION TO RELEASE ANALYTICAL RESULTS, GEOTECHNICAL DATA AND <br /> SITE ASSESSMENT INFORMATION <br /> i <br /> I <br /> I, the undersigned owner and/or operator of the property and/or facility <br /> located at 260 E. Main Street, Manteca, CA <br /> hereby authorize Canonie Environmental , Stockton, CA 983-1340 <br /> to release any and all analytical results, geotechnical data and site <br /> assessment information to the San Joaquin Local Health District as soon <br /> as it is available and at the same time it is provided to me or my <br /> representative. <br /> Owner/Operator: � _;� L ��' ��-Title: Owner <br /> Address 530 Yale St. Phone: (41g). ,586-0639 <br /> San Francisco, CA 94134 <br /> i <br /> Date: <br /> I <br /> EH 08 05 UGT 13 <br />